The document provides biographical information about Sondra Ford and Mary Dorn who work for Trusted Senior Specialists and information about the company. It then outlines topics that will be covered in an upcoming presentation on Medicare, including what Medicare is, its different parts, what is and isn't covered, premiums and costs. The presentation will review these topics, take questions, and invite people to future presentations and one-on-one meetings with specialists.
2. ABOUT THE MEDICARE GALS
Sondra Ford
Compliance Officer
•Native Houstonian.
•Has been in the Insurance Industry since 2007.
•Field agent with Trusted Senior Specialists since 2009.
•Experienced in call center and now compliance.
•Has a 2-week University child, and one that just turned 2.
Mary Dorn
VP of Agent Support
•Originally from Ohio, moved to Texas in 1990.
•Insurance Agent, licensed in many states.
•Has been helping our community since 2008.
•Has been with Trusted Senior Specialists since 2002.
•Is a Grandmother of 4, 3 girls and 1 boy.
3. ABOUT TRUSTED SENIOR SPECIALISTS
We began in Texas over 13 years ago and are now in 40-plus states across the country.
As members of the Better Business Bureau, we have an A+ rating and have been honored
as a Winner of Distinction at the 2011, 2012, 2013 Awards for Excellence.
For the past decade, we have established a name and reputation based on reliable service,
honesty, integrity and have built an Insurance Marketing Organization of over
3,000 agents in 42 states.
We are dedicated to assisting families, groups and individuals with their different insurance
needs such as: Life Insurance, Health Insurance, Final Expense, Long Term Care and Cancer.
We specialize in Medicare Supplements and Medicare Advantage Plans.
www.TrustedSeniorSpecialists.com
www.MedicareGals.com
4.
5. TOPICS FOR TODAY
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5.
WHAT IS MEDICARE?
MEDICARE PART A
MEDICARE PART B
WHAT IS NOT COVERED
PREMIUMS, DEDUCTIBLES, CO-INSURANCE:
HOW MUCH DOES MEDICARE COST?
6. QUESTIONS
7. PRESENTATION REVIEW
8. OPEN INVITATION!
6. WHAT IS MEDICARE?
• WHAT IS MEDICARE?
• WHO IS ELIGIBLE
• WHAT ARE THE DIFFERENT
PARTS OF MEDICARE
7. WHAT IS MEDICARE?
Medicare is a Federal Health Care Program for:
• PEOPLE AGE 65 AND OLDER
• PEOPLE YOUNGER THAN 65 WHO ARE DISABLED
• PEOPLE YOUNGER THAN 65 WHO HAVE
END-STAGE RENAL DISEASE (ESRD)
NOTE: People under 65 must have a disability and have
Collected Social Security Disability for at least 24 months
Before they qualify for Medicare; however there are exceptions.
8. WHAT IS MEDICARE?
There is no waiting period for those with:
•Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig’s Disease)
•Kidney Failure: End Stage Renal Disease (ESRD)
Medicare is administered by the Centers for Medicare and
Medicaid Services (CMS).
Enrollment into Medicare Parts A&B is handled by the Social
Security Administration (SSA).
9. WHAT IS MEDICARE?
What are the different parts of Medicare?
Part A – Hospital Insurance
Part B – Outpatient Medicare Insurance (Doctors)
Part C – Medicare Advantage Plans
Part D – Prescription Drug Plans
10. MEDICARE PART A
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Inpatient Hospital Care (Up to 150 days for a lifetime)
Psychiatric Hospital Care
Skilled Nursing Facility
Home Health Care; Intermittent Skilled Care Prescribed
by a Doctor
• Hospice; Pain Management Program for those who are
Terminally Ill
• Blood; Does not include the first 3 pints.
Blood must be received during hospital stay or
skilled nursing facility stay)
11. MEDICARE PART B
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Physician Visits
Diagnostic Testing
Rehabilitation Services
Durable Medical Equipment
Ambulance Services
Limited Benefits include Mental Health,
Outpatient Physical Therapy, Occupational Therapy,
and Speech Therapy
12. WHAT IS NOT COVERED?
In order to be covered by Medicare, all Part A and Part B
services must be medically reasonable and necessary.
There are some services that are NOT covered including:
•Routine Dental Care
•Routine Eye Exams
•Routine Hearing Care
•Routine Foot Care (Exception: Some foot care is covered
for diabetics)
•Acupuncture
13. PREMIUMS, DEDUCTIBLES, CO-INSURANCE
Part A Premium (2014):
•If you or your spouse have worked for 40 quarters: $0 per month
•30-39 quarters: $243 per month
•Less than 30 quarters: $426
Part A Deductible (2014):
•$1216. (This can happen several times throughout the year and covers
hospitalization costs for days 1-60)
Part A Co-Insurance (2014):
•Days 61-90: $304 per day
•Days 91-150: $608 per day
NOTE: There is no catastrophic limit on Out-of-Pocket expenses with
Original Medicare. (Parts A and B)
14. PREMIUMS, DEDUCTIBLES, CO-INSURANCE
Part B Premium(2014):
$104.90 (If your income is above $85,000 (single) or $170,000 (married
couple) then your Medicare Part B Premium may be higher)
Part B Deductible (2014):
$147.00 ( This is an annual deductible. You are responsible for this
deductible One Time Per Year)
Part B Co-Insurance (2014):
Medicare pays for 80%. You will typically be responsible for the remaining
20% of the Medicare approved amount.
15. PREMIUMS, DEDUCTIBLES, CO-INSURANCE
If your yearly income in 2011 (for what you pay in 2013)
or 2012 (for what you pay in 2014) was:
You pay
(in 2013 and 2014)
File individual tax return
File joint tax return
File married & separate tax return
$85,000 or less
$170,000 or less
$85,000 or less
$104.90
above $85,000 up to $107,000
above $170,000 up to $214,000
Not applicable
$146.90
above $107,000 up to $160,000
above $214,000 up to $320,000
Not applicable
$209.80
above $160,000 up to $214,000
above $320,000 up to $428,000
above $85,000 and up to $129,000
$272.70
above $214,000
above $428,000
above $129,000
$335.70
17. REVIEW
We have just reviewed Medicare: What it is, who is eligible and what
it covers. Based on the information we shared, you can see there
are gaps in the coverage Medicare provides. You will always be
responsible for paying your Premium(s) but there are options
available to help relieve you of some of the financial strain you may
have due to co-pays, deductibles and co-insurance amounts
generally paid out of pocket.
Tomorrow we will be discussing these coverage gaps and the
options you have to reduce your expenses.
You can register for tomorrow’s presentation at:
www.MedicareGals.com
18. REVIEW
If you’d like to speak with a specialist one on one, please call us at:
(281) 879-7711
Monday – Friday
9:00 a.m. to 7:00 p.m.
On behalf of Trusted Senior Specialists and The Medicare Gals, we
would like to thank you for joining us today.
We look forward to our next presentation in this series and hope you
will join us once again.
19. Thank you!
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